<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_title')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-coupon_title" data-rule="required" class="form-control" name="row[coupon_title]" type="text" value="{$row.coupon_title|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-coupon_price" data-rule="required" class="form-control" step="0.01" name="row[coupon_price]" type="number" value="{$row.coupon_price|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Send_type')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-send_type" class="form-control selectpicker" name="row[send_type]">
                {foreach name="sendTypeList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.send_type"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_type')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-coupon_type" data-rule="required" class="form-control selectpicker" name="row[coupon_type]">
                {foreach name="couponTypeList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.coupon_type"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mini_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mini_price" data-rule="required" class="form-control" step="0.01" name="row[mini_price]" type="number" value="{$row.mini_price|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Usage_type')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-usage_type" data-rule="required" class="form-control selectpicker" name="row[usage_type]">
                {foreach name="usageTypeList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.usage_type"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Useage_day')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-useage_day" class="form-control" name="row[useage_day]" type="number" value="{$row.useage_day|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Useage_start_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-useage_start_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[useage_start_time]" type="text" value="{$row.useage_start_time}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Useage_end_time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-useage_end_time" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[useage_end_time]" type="text" value="{$row.useage_end_time}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Claims_limit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-claims_limit" class="form-control" name="row[claims_limit]" type="number" value="{$row.claims_limit|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-status" class="form-control" name="row[status]" type="number" value="{$row.status|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>
